The spectrum of vascular anomalies includes entities like those described by Wortsman et al.1 in their article on ultrasound. The authors are capable of identifying distinctive sonographic characteristics of glomuvenous malformations (GVMs), which can be difficult to diagnose, leading to biopsies that may often be unnecessary.

Useful sonographic knowledge, like that proposed by Dr. Wortsman in this article, must always satisfy two criteria: it must be clear, and it must be accessible to the community of practitioners who require it in their clinical practice.

Thus, the characterization of vascular anomalies with B-mode and color and spectral Doppler ultrasound constitutes a clear three-pronged system2 that, when used together with physical examination and clinical history, allows practitioners to characterize GVMs as a specific clinical-sonographic entity with a specific underlying histology.

Ultrasound has a fundamental role to play in this group of diseases, which comprises a growing number of entities and subtypes. This approach should be explored as a means of avoiding biopsies and guiding treatment where appropriate.

If ongoing efforts to characterize vascular anomalies—including this article—continue in this direction, the immediacy of ultrasound and its capacity to distinguish vascular anomalies should very probably be taken into account in future classifications of the International Society for the Study of Vascular Anomalies (ISSVA).